The Medicare Fee-for-Service (FFS) Compliance programs prevent, reduce, and measure improper payments through medical review. We provide a number of programs to educate and support Medicare providers in understanding and applying Medicare FFS policies while reducing provider burden.
The Electronic Submission of Medical Documentation (esMD) system helps different entities eliminate the need to mail or fax paper documents. esMD allows:
Providers and suppliers to electronically submit medical documentation requested by the Centers for Medicare and Medicaid Services (CMS) for improper payment review and requests for prior authorization.
Review contractors (RCs) to submit Additional Document Requests (ADRs) to providers electronically.
RCs to exchange solicited documents with other CMS adjudicators electronically.
esMD reduces burden on providers and supports CMS’ broader eHealth Initiative.
Get Started with esMD
Providers can use esMD to submit documentation for the following Lines of Business (LOBs):
Suppliers can use esMD to submit documentation for the following LOBs:
RCs can use esMD to request information for the following LOBs:
- Requested documents to other CMS adjudicators
- Pre-Pay and Post-Pay Electronic Medical Documentation Request (eMDR) letters
Refer to Introducing esMD to New Providers RCs and HIHs (PDF) for benefits and other details.
Current Release Documents
The esMD technical team distributes the following documents for RCs and Health Information Handlers (HIHs) during the course of the release:
- Release Summary Document
- The RC/HIH Initial Technical Release Change Document
- The RC/HIH Final Technical Release Change Document
Visit esMD for Health Information Handlers and esMD For Review Contractors for the most current versions of these documents.
To align with the Centers for Medicare and Medicaid Services' (CMS) move of most of its Enterprise architecture to the Amazon Web Service (AWS) Cloud environment, esMD is planning to onboard the HIHs and RCs onto the AWS Cloud environment in a phased approach starting from the July 2022 release. This onboarding process will continue until all the HIHs and RCs are fully onboarded by the end goal of 2023.